We carried out a review of the data available to us about Compton Lodge on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Compton Lodge, you can give feedback on this service.
Compton Lodge is a residential home providing care for up to 34 older people. There were 29 people living at the home at the time of this inspection. Each person had their own room and shared communal facilities.
People’s experience of using this service and what we found
Two people spoke with us briefly. Each told us about how staff and registered manager responded to the requests they made and said that they appreciated the response they received.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
For more details, please see the full report which is on the Care Quality Commission website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Good (published 10 March 2021).
We undertook this targeted inspection to check on specific concerns we had about two complaints about personal care and potential risks for some people by leaving the home without a member of staff or someone else supporting them. As a result, we undertook a targeted inspection to review specific aspects of the key question of safe only.
We use targeted inspections to follow up on Warning Notices or to check concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.
We found no evidence during this inspection that people were at risk of harm from these concerns. Please see the safe section of this full report.
We also looked at infection prevention and control measures under the Safe key question. We look at this in all inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
The overall rating for the service has not changed following this targeted inspection and remains Good.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Compton Lodge on our website at www.cqc.org.uk.
Follow-up
We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
We found the following examples of good practice.
The service worked hard to encourage people to maintain socially distanced despite people living at the home finding it difficult to understand why this was necessary. The service had adjusted the living and dining areas to reflect how people liked to sit and dine with people they had good relationships with. Furniture had been re-arranged and people were encouraged to use more of the communal rooms available, which we saw people doing.
The service had allowed visits from friends and families at times during the pandemic when precautionary measures were relaxed. Due to recent rise in infections visits into the house were limited to those people who were receiving end of life care. The provider had built a “Pod” in which people could receive their visitors. This was a wooden building in the garden. This allowed visitors and people using the service to see each other in comfort whilst still maintaining social distance and minimising the risk of infection. Where visits had been restricted the service had used tablet devices and telephones to enable people to maintain contact with those most important to them. Visitors had also been able to see their relatives through the garden gate, weather permitting.
Compton Lodge is a residential home providing care for up to 32 older people. There were 27 people living at the home at the time of this inspection. Each person had their own room and shared communal facilities which provided people with ample space in different lounge and dining areas, as well as in the garden.
People’s experience of using this service and what we found
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
People were kept safe from harm and if any concerns about people’s wellbeing arose the service took the necessary steps to respond. Staff we spoke with were able to describe what they did to minimise the risks that people faced and liaised appropriately with other health and social care professionals to achieve this.
The service understood people’s needs and made detailed plans of people’s care. The care provided was agreed in consultation with people using the service and, if relevant, their families.
Staff were caring. People we spoke with told us this and we observed many positive caring interactions between people using the service, their relatives and staff. People were supported to have choice in their daily lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
People were treated with dignity and respect by staff working at the home.
The way in which the service operated was kept under review by the provider had improved. Lessons had been learnt since our previous focused inspection, in particular about monitoring the performance around the safe use of medicines.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was Requires Improvement as a result of a focused unannounced inspection (Inspection report published on 8 February 2019). At our previous unannounced focused inspection in September 2018 there had been concern about people not always receiving their medicines in a safe way as errors were being made and these had not been identified. Lessons learnt from previous incidents was not suitably evidenced as occasional mistakes had still been made in connection with medicines. At this inspection the provider was able to demonstrate that lessons had been learnt and action had been taken to minimise the potential for further medicines errors and the service had improved to Good.
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
We carried out an unannounced inspection on the 19 and 21 September 2018. At our last inspection on 10 and 12 January 2018 the service was rated as Good. As a result of this inspection the service has been rated as Requires Improvement.
We carried out an unannounced comprehensive inspection of this service on 10 and 12 January 2018. After that inspection we received concerns in relation to the use of medicines at the home due to a controlled medicine having been given in error. As a result, we undertook a focused inspection to look into those concerns. This report covers our findings in relation to this topic and other areas we examined. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for [Compton Lodge] on our website at www.cqc.org.uk
Earlier this year, after our previous inspection, there had been a delay in following up the receipt of a prescribed medicine needed due to sudden illness. Since that time there was a recorded omission from a controlled drug register entry in August 2018, a medicine error where an incorrect medicine had been given and an error by the dispensing pharmacy which was picked up by the service, but not until after the medicine had also been given. These had fortunately not resulted in harm to anyone. Action had been taken as a result of these occasional errors and improvements had been made although errors had still occurred. The provider has changed pharmacy provider since in order to respond to errors being made by the previous pharmacy provider.
There was a registered manager in place at the time of the inspection. There had been a change since our last inspection in January 2018. The previous manager had left the provider organisation in June 2018 and had been replaced by a manager who had previously been the registered manager of another care home operated by the same provider. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
Staff had received training in the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). The service was clear about obtaining consent to care and had done so in each of the care plans that we viewed. Consent was obtained from people themselves, but if they lacked capacity, and if legally permitted to do so, relatives provided signed consent. One person, of the six currently identified as lacking capacity, had a relative with lasting power of attorney (LPA) noted on their care plan. The Office of the Public Guardian registered number of the LPA was noted on the care plan, but a physical copy of the LPA had not been obtained from the relative, which was being followed up by the service.
There were systems in place to safeguard people and staff had a good understanding of keeping people safe from harm or abuse. Risk assessments formed part of each person’s care plan and covered risks that staff needed to be aware of to keep people safe.
People had a Personal Emergency Evacuation Plan on their care record (PEEP) which informed staff how to support the person should evacuation be necessary in the event of fire. The home was undergoing a renewal of the fire alarm system at the time of this inspection, during which the current fire alarm system was still in use.
Recruitment practices ensured staff were appropriately checked prior to employment to ensure they were suitable to work with the people using the service. There were sufficient staff available and deployed to meet people’s needs and staff were trained about their work.
People were supported to eat drink and maintain a balanced diet. There were menus on display in pictorial form. People were supported appropriately during meal times which we saw happening during this inspection.
People were supported to keep well and had access to the health care services they needed.
There were opportunities for people’s voices to be heard. Meetings and social events were organised for people using the service and their relatives.
As a result of this inspection we identified that the service requires improvement in the areas of safe and well-led. Further information is in the detailed findings below.
Compton Lodge is a residential care home for up to thirty two older people, each accommodated over three floors with communal living space on the ground floor. At the time of our inspection there were twenty six people using the service.
This unannounced inspection took place on 10 and 12 January 2018. At the last inspection on 19 January 2016 the provider met all of the legal requirements we looked at and was rated good.
At this inspection we found the service remained Good.
The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.
All staff we spoke with understood their duty to protect the people in their care. Staff knew what to do in order to protect people from abuse and how to identify and minimise potential risks to people’s health and welfare. Medicines were safely administered, managed and stored.
There were sufficient staff to meet people’s needs. People, and relatives, told us that they were happy and that staff provided safe and good care.
Care staff undertook training which helped them to carry out their role. The supervision and appraisal system also supported them to carry out their work.
People were supported to consent to care and the service operated in line with the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards, consulting with people and their relatives about their wishes and needs.
People were supported to maintain good health. People had access to health care services whenever this was needed and appropriate advice was obtained from healthcare professionals when required. People received a nutritionally balanced diet to maintain their health and wellbeing.
The service carried out assessments of people’s needs before they moved in to make the right decision about whether the service could provide the care and support that people needed. Care plans described each person as an individual and were tailored to their unique needs. Care plans were regularly reviewed and any changes to people’s needs were recognised and action was taken to respond.
The service had a clear management structure in place. The service had a range of quality assurance, consultation and monitoring systems in place. The provider listened and responded to the views of people who used the service, relatives and other health and social care professionals.
At this inspection we saw improvements had been made. We saw that risk assessments and care plans were person centred and reviewed regularly, care plans were being followed and an annual fire risk assessment had been carried out in June 2015.
Compton Lodge is a residential care home for up to thirty two older people. At the time of our inspection there were twenty nine people using the service.
There was a registered manager in place at the time of the inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
There were systems in place to safeguard people and staff had a good understanding of the different types of abuse and how they would look out for signs.
Risk assessments formed part of the person’s agreed care plan and covered risks that staff needed to be aware of to keep people safe.
People had a Personal Emergency Evacuation Plan on their record (PEEP). Their PEEP identified the level of support they needed to evacuate the building safely in the event of an emergency.
Recruitment practices ensured staff were appropriately checked prior to employment to ensure they were suitable to work with the people using the service.
There were sufficient staff available and deployed to meet people’s needs.
Medicines were stored, administered and recorded appropriately by staff who had undertaken relevant training.
Staff received training and support to help them carry out their work role and demonstrated good knowledge on the subjects they were asked about, including promoting independence, choice, dignity, engagement and person centred care.
Staff had received training in the Mental Capacity Act 2005 (MCA) and the Depravation of Liberty Safeguards (DoLS) .They able to describe people’s rights and the process to be followed if they were identified as needing to be assessed under DoLS.
People were supported to eat drink and maintain a balanced diet. There were menus on display in pictorial form. People were supported appropriately during meal times.
People were supported to keep well and had access to the health care services they needed.
We saw that staff received training on ‘Rights, Choice and Risks’ and this also included equality and diversity. Aspects of peoples unique needs relating to this were included in peoples care plans, including race, sexual orientation and beliefs.
A copy of the complaints leaflet was on display on the notice board at the service. Staff knew how to support people appropriately to make a complaint.
There was evidence of regular audits and spot checks undertaken by the management team, including checks of care records, communication and staff practice.
There were opportunities for people’s voices to be heard. Meetings were organised for people using the service and their relatives.
This unannounced inspection took place on 24 February 2015. Our previous inspection took place on 12 November 2103 and we found the service met the regulations inspected.
Compton Lodge is a residential care home for up to 32 people over 65 years of age. Each person has their own bedroom and has access to assisted bathrooms and walk in showers. There is a large communal lounge, a smaller lounge and a separate dining room. At the side of the home there is a large garden area. The home is situated in a residential area near Swiss Cottage in Camden, North London. At the time of our inspection there were 29 people using the service.
There was a registered manager in place at the time of our visit. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
People were not always supported safely as risk assessments were not person centred and did not always demonstrate how people should be supported safely. They were not always easily accessible and were not reviewed in accordance with the provider’s documentation.
There was a lack of involvement of people and their relatives in care planning. Some people and their relatives told us they were not involved in reviews of care plans and a survey of people using the service undertaken by the provider indicated the same. We also noted that the care records system used were not person centred, meaning individually focused on the needs of the person. They were also not regularly reviewed in accordance with the provider’s own documentation.
Medicines were stored and administered safely and some people managed these themselves. However some staff had not had the required competency assessment for the administration of medicines.
Staff had adequate skills and knowledge to support people effectively and we saw evidence of training in staff files that we looked at. Staff told us the induction they received was good and covered all the core training courses as well as including a period of shadowing more senior staff.
Staff had some understanding of the Mental Capacity Act 2005 and how to support people using the principles of the Act. However staff we spoke with had limited understanding of the Deprivation of Liberty Safeguards (DoLS) and changes that had occurred as a result of the Supreme Court judgement in 2014. DoLS exist to protect the rights of people who lack the mental capacity to make certain decisions about their own wellbeing. Services should only deprive someone of their liberty when it is in the best interests of the person and there is no other way to look after them, and it should be done in a safe and correct way. We noted that only a quarter of the staff team had undertaken training concerning DoLS. There were no applications for DoLS at the time of our visit. This lack of knowledge of the DoLS may have led to people being unlawfully deprived of their liberty.
We saw three care files and each person had “Do Not Attempt Resuscitation” (DNAR) forms in their records to record their wishes on this matter. However on two of the files there was no evidence that people and their relatives were involved in the discussions regarding this. This could have meant that people and their relatives may not have had a good understanding of the implications of this instruction should the need for resuscitation arise.
Staff developed positive and caring relationships with people. There was a warm and caring atmosphere and we saw good interaction between staff and people using the service. Staff demonstrated dignity and respect and encouraged people to be independent when supporting them with activities. We saw one person being supported to walk around the garden and other staff were seen sitting beside people talking and laughing.
We saw that there were aspects of the service that were responsive, including the activities people were offered and the way the service supported people to continue with activities they had done before they came to the service.
The registered manager was friendly and approachable and was supported well by the deputy manager, the quality assurance manager and the area manager. They recognised that the care plans and risk assessment systems in place were not adequate and told us there were plans in place to make changes and improvements.
At this inspection we found breaches of regulations in relation to care and welfare and assessing and monitoring the quality of service provision. You can see what action we told the provider to take at the back of the full version of the report.
The home was bright, warm and clean. We saw that people were relaxed and appeared to get on well together. We saw staff providing care and support in a friendly unhurried way. People described staff as 'gentle,' 'polite' and 'very nice.' They were generally happy with living at the home. One person told us 'If I didn't like it here, I'd leave.' The home arranged appropriate activities for people using the service.
The provider maintained both paper and electronic records. The electronic records indicated that reviews of some people's care plans were overdue.
Staff members were suitably inducted and trained. They told us they were appropriately supported by the provider to carry out their duties.
Although people were given the opportunity to comment on the quality of the service, there had been no residents' meetings for several months. The provider had conducted quality surveys of people using the service, but there had been delays in passing the results back to the home for necessary action.
This report is supplemental to our report published in October 2012.
We made this visit on the 31st January 2013 to check that the provider had made the necessary improvements to meet the standard. We inspected a number of paper and computer records relating to people using the service and we spoke the home's manager. On this occasion, we did not speak with any people using the service. We found that the provider had taken appropriate action and was compliant with Outcome 21.
The inspection team was led by a CQC inspector joined by an additional CQC inspector and an Expert by Experience; people who have experience of using services and who can provide that perspective.
We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.
People told us that the home was 'very comfortable,' and that they had no complaints they can think of. One person said the food at the home was 'lovely.' Another said that it 'couldn't be much better.' All the residents that we spoke with said they felt safe in the home and had not experienced any incidents of abuse. One resident said, 'the staff are very good and kind to everyone.' and another described the manager as 'absolutely wonderful.'
Staff are helpful and cheerful and the care delivered is very good. When people need to see a doctor for medical reasons, this is facilitated by the staff. People using the service feel comfortable to report any concerns to the home manager, should this be necessary.
Medication is given to people using the service on time and as prescribed.